Individual
NICHOLAS A MASSOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4121 CLOCK TOWER AVE, CALDWELL, ID 83607-5006
(208) 459-7800
(208) 455-8452
Mailing address
4121 CLOCK TOWER AVE, CALDWELL, ID 83607-5006
(208) 459-7800
(208) 455-8452
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
D 3848 OS
ID
Other
Enumeration date
07/04/2006
Last updated
07/09/2007
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